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Couple of Questions

Hello Dr.,

I appreciate your help in advance. And I understand how tough it is for you to diagnose over the internet so I do not expect that you will. But, I do have a couple questions. I'll give you the run down of what happened to me. I am 23yro male. Anyway, I had unprotected sex with a girl last year that may have not been the cleanest girl. (My last sexual intercourse before this was in early April with a clean girlfriend). The sex with the random girl lasted only between 2-5 minutes and was last July. After 6 weeks I got tested for HIV, HSV (not type specific), Syphillis, Gonnoreaha, and Chlamydia, all came back negative.

So about 6 weeks ago from today I noticed a really small pimple-looking bump on my penis. I didnt bother poping it until I noticed that it was still there last week and it was still the same size. No puss came out of it, just blood. Anyway a couple of days ago i noticed a similar bump above it. and it has not healed, so I popped them both and they both bled.

I did go see a doctor after the second one came around, he thought it was warts and applied something to them. I cant remember he did the inspection and application really fast. Because of that I went to another doctor and he said they look like nothing but it could be herpes or ingrown hairs so he took a swab and sent it out for testing. I am seeing my family doctor tomorrow because first of all I think it will be more personal for him and I won't be in and out in 30 seconds. My questions are:

1. Could herpes have been in my system for 1 year without symptoms? And if so why are they coming about right now?
2. How could I have tested negative for them before but have them now?
3. If they are warts am i spreading them by poping them?
4. Should I even be concerned in the first place?

Anyway I was diagnosed not to long ago with GAD, (mild) OCD and panic disorder, and I feel as though these are making me worry excessively to the point I'm on here! Thanks again.
5 Responses
239123 tn?1267651214
Molluscum contagiosum sounds like a possibility.  MC usually appears as shiny pink bumps, often with a dimple in the center.  A hard white core can be expressed (but not liquid pus), followed by brisk bleeding.  Misdiagnosis as genital warts is pretty common.  (This can be especially confusing since many of the treatments for warts -- e.g., freezing, podophyllin, imiquimod [Aldara] -- are effective against both conditions.)  The timing also is right.  Sexually acquired MC usually shows up within a couple of months of exposure.  incubation period usually is 1-2 months after exposure.

MC is most common in young children, but is fairly common in the genital area is adults.  It is best described as sexually transmissible, but not always sexually transmitted.  It is a completely benign infection, with no known complications.  Treatment is easy, usually freezing with liquid nitrogen.  Or, if there aren't too many lesions, simply popping them -- as you already have started to do -- cures the problem.  New lesions usually stop showing up after a month or two.  But it's very important to wash with soap and water after handling the lesions; they are easily spread to nearby skin.

That said, folliculitis (infected hair follicle) or just garden-variety pimples also are possible.  Herpes sounds possible but unlikely.

To the specific questions:

1,2) Your description doesn't sound like herpes.

3) Warts don't "pop" and generally don't bleed briskly after trying to do so.

4) This doesn't sound like anything of great concern.  Follow-up with your plan to return to your personal doctor.  Mention molluscum contagiosum.  If s/he doesn't know or is unfamiliar with MC as a genital infection, I suggest you decline additional treatment until the diagnosis is clear and ask for referral for another opinion.  A dermatologist would be a good bet; or your local health department STD clinic, which undoubtedly has a lot of experience with MC as well as other genital infections.

Good luck--  HHH, MD
239123 tn?1267651214
I should have added that it might not be possible for anyone to make an accurate diagnosis at this point, i.e. if the only 2 lesions you had have already been "popped".  No matter what the original cause, at that point MC, herpes, warts, or folliculitis all would look pretty much the same.  In that case, sit tight and see if new lesions appear -- then see a provider promptly, before popping or picking at them.
Avatar universal
Thanks for your advice and follow up.
Avatar universal
Sorry Dr. for this late follow up. But I did end up seeing my family doctor he said it might probably herpes because they have scabs, but i tried to tell him that they were bleeding badly before the scabs cemented on them. and by bleeding I said red blood! anyway he did another swab and let me go gave me some meds to take. Now, I think I would know if I had herpes, I have never experienced any herpes symptoms over the last year, so why now?. I feel like all the doctors here are giving me the worst case scenario.

Either that or I really had a false negative hsv blood test, herpes infection due to 1 unprotected sexual encounter, and 1 year before my first outbreak for herpes symptoms to appear, its almost like i am out of luck if that is all true! It's really frustrating.  I did make a point to a see a dermatologist and probably won't because over the last couple of days (since my last post) the pimple like lesions have healed almost completely (first one is alittle pinkish with a bump still), However, I did notice a dimple in one of them. But I guess I'll have to wait for those swabs to get back to be sure.

Thanks again for your help. I wish there were more doctor's as dedicated as you and Dr. Hook in educating the masses. (especially the ones with severe anxiety lol)
239123 tn?1267651214
I cannot make a specific diagnosis and cannot provide any more information than I already did.  It sounds like your family doctor might be unfamiliar with MC as a genital infection in adults. The dermatologist will be able to advise you, however.  But as I said, don't get your hopes up for a definitive answer, if all existing lesions have been expressed (and perhaps cured).  In any case, you can expect the HSV tests to be negative.
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